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Bissonnette R, Eichenfield LF, Simpson E, Thaçi D, Kabashima K, Thyssen JP, Guttman-Yassky E, Nunes FP, Gamalo M, Ahmad F, Kuligowski M, Sun K, Pipper C, Christensen AW, D'Angelo P, Milutinovic M, Guettner A, Silverberg JI. Estimands for atopic dermatitis clinical trials: Expert opinion on the importance of intercurrent events. J Eur Acad Dermatol Venereol 2023; 37:976-983. [PMID: 36652273 DOI: 10.1111/jdv.18881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/05/2023] [Indexed: 01/19/2023]
Abstract
Despite the emergence of novel targeted treatments for atopic dermatitis (AD), there is a lack of guidelines on standardizing analysis of clinical trial data. To define and estimate meaningful treatment comparisons, several factors, including intercurrent events, must be taken into account. Intercurrent events are defined as events occurring after treatment initiation that affect either the interpretation or existence of the measurements associated with clinical questions of interest. Due to the relapsing, unpredictable nature of AD, intercurrent events frequently occur in AD trials, such as use of rescue therapy for intense itch and sleep deprivation. Despite the impact of intercurrent events in AD, they are often handled in an inconsistent manner across trials, which limits results interpretation. The estimand framework is increasingly used to estimate treatment effects while accounting for intercurrent events. This review explores how guidance from the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) on the use of estimands can be applied to support AD clinical trial design and analysis. We propose that estimands are used in AD trials and defined early during trial design. The use of estimands can provide clinicians with interventional trial results that are more reflective of clinical practice, help facilitate comparisons across clinical trials, and are more informative to enable improved treatment selection for patients.
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Affiliation(s)
| | - L F Eichenfield
- Departments of Dermatology and Pediatrics, University of California, San Diego, California, USA
| | - E Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - D Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - E Guttman-Yassky
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - F P Nunes
- Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA
| | - M Gamalo
- Pfizer Inc., Collegeville, Pennsylvania, USA
| | - F Ahmad
- Galderma Laboratories, Fort Worth, Texas, USA
| | | | - K Sun
- Incyte Corporation, Wilmington, Delaware, USA
| | - C Pipper
- LEO Pharma A/S, Ballerup, Denmark
| | | | - P D'Angelo
- Innovaderm Research, Montreal, Quebec, Canada
| | | | | | - J I Silverberg
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Paller A, Blauvelt A, Soong W, Hong C, Schuttelaar M, Schneider S, Moerch M, Simpson E. MEANINGFUL RESPONSES IN TRALOKINUMAB-TREATED ADOLESCENTS WITH ATOPIC DERMATITIS NOT ACHIEVING IGA 0/1 AT WEEK-16. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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3
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Grimbly C, Escagedo PD, Jaremko JL, Bruce A, Alos N, Robinson ME, Konji VN, Page M, Scharke M, Simpson E, Pastore YD, Girgis R, Alexander RT, Ward LM. Sickle cell bone disease and response to intravenous bisphosphonates in children. Osteoporos Int 2022; 33:2397-2408. [PMID: 35904681 PMCID: PMC9568449 DOI: 10.1007/s00198-022-06455-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED Children with sickle cell disease (SCD) have the potential for extensive and early-onset bone morbidity. This study reports on the diversity of bone morbidity seen in children with SCD followed at three tertiary centers. IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications. INTRODUCTION To evaluate bone morbidity and the response to intravenous (IV) bisphosphonate therapy in children with SCD. METHODS We conducted a retrospective review of patient records from 2003 to 2019 at three Canadian pediatric tertiary care centers. Radiographs, magnetic resonance images, and computed tomography scans were reviewed for the presence of avascular necrosis (AVN), bone infarcts, and myositis. IV bisphosphonates were offered for bone pain management. Bone mineral density was assessed by dual-energy X-ray absorptiometry (DXA). RESULTS Forty-six children (20 girls, 43%) had bone morbidity at a mean age of 11.8 years (SD 3.9) including AVN of the femoral (17/46, 37%) and humeral (8/46, 17%) heads, H-shaped vertebral body deformities due to endplate infarcts (35/46, 76%), and non-vertebral body skeletal infarcts (15/46, 32%). Five children (5/26, 19%) had myositis overlying areas of AVN or bone infarcts visualized on magnetic resonance imaging. Twenty-three children (8/23 girls) received IV bisphosphonate therapy. They all reported significant or complete resolution of bone pain. There were no reports of sickle cell hemolytic crises, pain crises, or stroke attributed to IV bisphosphonate therapy. CONCLUSION Children with SCD have the potential for extensive and early-onset bone morbidity. In this series, IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications.
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Affiliation(s)
- C Grimbly
- Department of Pediatrics, University of Alberta, 4-584 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 2R7, Canada.
- Women's and Children's Health Research Institute, Alberta, Canada.
| | - P Diaz Escagedo
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montreal, Montreal, QC, Canada
| | - J L Jaremko
- Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - A Bruce
- Department of Pediatrics, University of Alberta, 4-584 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 2R7, Canada
- Women's and Children's Health Research Institute, Alberta, Canada
| | - N Alos
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montreal, Montreal, QC, Canada
| | - M E Robinson
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - V N Konji
- The Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - M Page
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - M Scharke
- The Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - E Simpson
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Y D Pastore
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montreal, Montreal, QC, Canada
| | - R Girgis
- Department of Pediatrics, University of Alberta, 4-584 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 2R7, Canada
- Women's and Children's Health Research Institute, Alberta, Canada
| | - R T Alexander
- Department of Pediatrics, University of Alberta, 4-584 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 2R7, Canada
- Women's and Children's Health Research Institute, Alberta, Canada
| | - L M Ward
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Pediatric Bone Health Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
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Becksfort J, Lucas J, Hsu C, Vajapeyam S, Wang C, Simpson E, Chiang J, Armstrong J, Soike M, Young M, Kann B, Li Y, Li C, Lu Z, Kline C, Meuller S, Gajjar A, Merchant T, Baker S, Patay Z, Wright K, Poussaint T, Tinkle C. Conventional and Cross-Channel MR Radiomic Features do Not Predict Histone H3 Status in DIPG: Genomic and Clinical Evaluation of a Multi-Institutional Cohort. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Baghoomian W, Simpson E. 381 Assessing the ease of use and adherence of topical corticosteroid drug delivery devices in caregivers of pediatric patients with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Baghoomian W, Jacobson M, Kastala A, Thibau I, Simpson E, Smith Begolka W. LB909 Understanding the motivating factors and barriers to participation in eczema clinical trials among patients and caregivers. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Calco G, Baghoomian W, Jacoby D, Simpson E. 405 Atopic dermatitis patients have decreased epidermal innervation but increased neuronal substance p expression. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Berdyshev E, Simpson E, Bronova I, Pavel A, Soong W, Antaya R, Imafuku S, Røpke M, Jiang L, Guttman-Yassky E, Leung D. 399 Tralokinumab treatment modifies stratum corneum lipid composition in skin of adolescents with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Beck L, Boguniewicz M, Hata T, Fuxench Z, Simpson E, De Benedetto A, Ko J, Ong P, Yoshida T, Gallo R, Lussier S, David G, Schlievert P, Gill S, Rudman Spergel A, Leung D. 519 Rapid reduction in S. aureus & cytotoxins in dupilumab treated atopic dermatitis subjects. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Baghoomian W, Dunlap R, Chang A, Foster E, Simpson E. 335 Developing a treatment decision aid for patients with moderate to severe atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bauman M, Hellinger A, Pluym CV, Bhat R, Simpson E, Mehegan M, Knox P, Massicotte M. Online KidClot education for patients and families initiating warfarin therapy: The eKITE study. Thromb Res 2022; 215:14-18. [PMID: 35594736 PMCID: PMC9755220 DOI: 10.1016/j.thromres.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 01/12/2023]
Abstract
Anticoagulation with Vitamin K antagonists (VKA) has always posed challenges in terms of monitoring requirements. These challenges were further exacerbated in the setting of the COVID-19 pandemic, with limited access to and/or avoidance of laboratory testing. The importance of utilizing point of care (POC) health technology for individualized patient management is salient. The foundation of effective home INR monitoring is establishing patient knowledge about their therapy and INR testing proficiency. The eKITE series was developed to support patients in establishing foundational knowledge required for VKA (warfarin) management and INR monitoring. The primary objectives were to evaluate eKITE, a patient-oriented innovative online education program for warfarin therapy, participant learning stress, and patient preference for online learning. This multi-center prospective study provided patients access to warfarin online education. Participants were required to complete written quizzes assessing warfarin knowledge of key concepts proficiency and identifying knowledge deficits. Patient preference, evaluating calm (lack of anxiety) while learning, and an INR on a home meter was completed. Participants performed INR tests at home and reported INRs by telephone. The analysis included 144 children and caregivers enrolled at five US and CDN sites. Most indications for anticoagulation were cardiac (congenital or acquired heart disease) with varied INR target ranges. Mean knowledge scores for warfarin and INR self-testing modules were 97%, with low anxiety with TTR of 84%. Patient preferred online learning. eKITE is an effective teaching modality for warfarin/home INR monitoring with safe INR testing and warfarin management that is appropriate for pediatrics and adults alike. PROLOGUE: The whir in the hallways is deafening. Lights bright, alarms are ringing in a chorus of unsynchronized beeps and screeches. It has been more than a week since I have slept. Snuggled beside me is my precious child, whining and equally irritated with the asynchronous symphony, further compounded by anxiety, procedures, and pain. The sun has broken. The staff smiles are welcoming and incessant, as one after one, they approach hurried, urgent, assiduous, their need to coach me for our upcoming departure to the warmth of home. Each provides essential information that I will require to keep my child, my treasure, safe and healthy. Yet, my eyes are heavy, blurred, and my brain foggy, trapped in a dark heavy cloud. How am I to follow? Comprehend? and retain anything? As they instruct, my precious child yearns for loving arms, compassion and love, whining, crying in disquiet. Overwhelmed does not adequately describe my ineffable exhaustion. Amidst this, how am I to learn about warfarin? Such a challenging medication, with so much to know. Concentrate, I tell myself, focus; now is my only opportunity to learn. I must be alert. It seems to be nonsensical.
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Affiliation(s)
- M.E. Bauman
- Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada,Corresponding author at: KidClot Pediatric Thrombosis Program, University of Alberta, Stollery Children's Hospital, 3-585 ECHA, 11405-87 Ave NW, Edmonton, Alberta T6G 1C9, Canada
| | | | | | - R. Bhat
- Division of Hematology/Oncology/Stem Cell Transplant, Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL, USA
| | - E. Simpson
- Children's Hospital of Eastern Ontario, ON, Canada
| | | | - P. Knox
- Alberta Children's Hospital, Canada
| | - M.P. Massicotte
- Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
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Lanfranchi V, Jones N, Read J, Fegan C, Field B, Simpson E, Revitt C, Cudd P, Ciravegna F. User attitudes towards virtual home assessment technologies. J Med Eng Technol 2022; 46:536-546. [PMID: 35730495 DOI: 10.1080/03091902.2022.2089250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Telehealth has long been highlighted as a way to solve issues of efficiency and effectiveness in healthcare and to improve patients' care and has become fundamental to address patients' needs during the COVID-19 pandemic; however previous studies have shown mixed results in the user acceptance of such technologies. Whilst many previous studies have focussed on clinical application of telehealth, we focus on the adoption of telehealth for virtual assessments visits aimed to evaluate the suitability of a property where a patient is discharged, and eventual adaptations needed. We present a study of stakeholders' attitudes towards such virtual assessment visits. The study has been carried out with healthcare professionals and patients and allowed us to identify user attitudes, barriers and facilitators for the success of virtual assessment visits from the point of view of healthcare professionals and patients. Finally, we discuss implications for designers of telehealth services and guidelines that can be derived from our study.
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Affiliation(s)
- V Lanfranchi
- Department of Computer Science, The University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK.,NIHR Devices for Dignity, MedTech Co-operative Affiliate, Sheffield, UK
| | - N Jones
- Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK
| | - J Read
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - C Fegan
- Department Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - B Field
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E Simpson
- Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK
| | - C Revitt
- Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK
| | - P Cudd
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - F Ciravegna
- Department of Computer Science, The University of Sheffield, Sheffield, UK
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13
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Hadjigeorgiou E, Clark B, Simpson E, Coles D, Comber R, Fischer A, Meijer N, Marvin H, Frewer L. A systematic review into expert knowledge elicitation methods for emerging food and feed risk identification. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.108848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Simpson E, Lacour J, Beck L, Zhang H, Aamodt K, ROSSI A. P196 PATIENT PERCEPTION OF TREATMENT WITH LONG-TERM DUPILUMAB MONOTHERAPY IN ADULTS WITH MODERATE-TO-SEVERE ATOPIC DERMATITIS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Simpson E, Cork M, Arkwright P, Deleuran M, Chen Z, Rodriguez Marco A, Cyr S, Harel S. P193 DUPILUMAB DECREASES TOTAL AND ALLERGEN-SPECIFIC IGE IN ADOLESCENTS WITH MODERATE-TO-SEVERE ATOPIC DERMATITIS (AD). Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Silverberg J, Simpson E, Gooderham M, Lebwohl M, Fargnoli M, Tsianakas A, Kerkmann U, Valdez H, Biswas P, Levenberg M. P152 CHARACTERIZING THE EFFECTIVENESS OF ABROCITINIB IN SUBTHRESHOLD RESPONDERS IN THE MAINTENANCE PHASE OF JADE REGIMEN. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Papp K, Szepietowski J, Kircik L, Toth D, Eichenfield L, Forman S, Kuligowski M, Venturanza M, Sun K, Simpson E. 208 Long-Term Safety and Disease Control With Ruxolitinib Cream in Atopic Dermatitis: Results From Two Phase 3 Studies. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Reich K, Simpson E, Wollenberg A, Bissonnette R, Abe M, Cardillo T, Janes J, Sun L, Chen S, Silverberg J. 041 Efficacy with continuous dosing, down-titration, or treatment withdrawal after successful treatment with baricitinib in patients with moderate-to-severe atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Guttman E, Nosbaum A, Simpson E, Weidinger S. Pioneering Global Best Practices in Atopic Dermatitis: Results from the Atopic Dermatitis Quality of Care Initiative. Clin Exp Dermatol 2021; 47:303-311. [PMID: 34382243 DOI: 10.1111/ced.14880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by unrelenting pruritus and recurrent eczematous lesions. It affects up to 15% of children and adolescents and up to 5% of adults and confers a high and multifactorial burden to patients, families, and society. With increasing awareness of this substantial burden, AD has become a priority for healthcare systems. OBJECTIVE The Atopic Dermatitis Quality of Care (ADQoC) Initiative set out to describe good practices for addressing the challenges that impede the management of AD. METHODS The Initiative carried out a literature review and surveyed 32 expert care centres, catalogued findings, and analysed and elucidated global challenges to AD care along with good practice implementations that can address them. RESULTS The four challenges to quality care for AD are: misconceptions about AD; delayed referral and access to AD specialists; poor patient access to AD treatments and poor adherence to medications; and managing the complexity of atopic dermatitis and its comorbidities. The Initiative highlighted five of ten good practice implementations as high priority for any AD care centre to focus: clinical assessment and diagnosis; a structured multidisciplinary care team; monitoring and evaluating care quality; patient education and communication; and collaboration and exchange with patient groups. CONCLUSIONS These implementations can provide benefits for patients, healthcare providers, and the healthcare system. They directly contribute to the efficacy of treatment; improved healthcare provider efficiency; improved education; and improved costs to healthcare systems. The Initiative was launched on https://atopicdermatitiscare.kpmg.co.uk/ to provide an easy-to-use educational platform.
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Affiliation(s)
- E Guttman
- Mount Sinai School of Medicine, New York, USA
| | - A Nosbaum
- Centre Hospitalier Universitaire, Lyon, France
| | - E Simpson
- Oregon Health and Science University Hospital, Portland, USA
| | - S Weidinger
- University Hospital Schleswig-Holstein, Kiel, Germany
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Hopkins A, Lerner K, Grinich E, Ahn J, Choi Y, Simpson E. 321 The frequency and utility of drug cessation trials in older adults with chronic eczematous dermatitis of unknown etiology. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Simpson E, Lee M, Brar K, Kuligowski M, Venturanza M, Sun K, Toth D. 329 Efficacy of ruxolitinib cream in adults and adolescents with atopic comorbidities. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Forman J, Yoshida T, Lillis J, Gill A, Corbett A, Cahill M, Lockhart A, Simpson E, Boguniewicz M, Hanifin J, De Benedetto A, David G, Leung D, Schlievert P, Gill S, Beck L. 189 Microbial expression of lantibiotics may explain discrepancies between S. aureus culturability and metagenomics in atopic dermatitis subjects and healthy controls. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beck L, Boguniewicz M, Hatta T, Chiesa Fuxench Z, Simpson E, De Benedetto A, Ko J, Ong P, Yoshida T, Gallo R, Schlievert P, Gill S, Mosmann T, Berdyshev E, David G, Lussier S, Rudman Spergel A, Leung D. 666 Effect of dupilumab on the host-microbe interface in atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Blauvelt A, Szepietowski J, Papp K, Simpson E, Silverberg J, Kim B, Kwatra S, Kuligowski M, Venturanza M, Sun K, Kircik L. 313 Itch-free state in patients with atopic dermatitis treated with ruxolitinib cream. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simpson E, Bissonnette R, Kuligowski M, Venturanza M, Sun K, Silverberg J. 311 Effects of ruxolitinib cream in patients with atopic dermatitis with head and/or neck involvement. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, Williams HC, Schmitt J, Gabes M, Howells L, Stuart BL, Grinich E, Pawlitschek T, Burton T, Howie L, Gadkari A, Eckert L, Ebata T, Boers M, Saeki H, Nakahara T, Katoh N. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol 2021; 185:139-146. [PMID: 33393074 PMCID: PMC8359383 DOI: 10.1111/bjd.19751] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 12/18/2022]
Abstract
Background The Harmonising Outcome Measures for Eczema (HOME) initiative has established a core outcome set of domains for atopic eczema (AE) clinical trials. Previous consensus meetings have agreed on preferred instruments for clinician‐reported signs (Eczema Area and Severity Index, EASI) and patient‐reported symptoms (Patient‐Oriented Eczema Measure, POEM). This paper reports consensus decisions from the HOME VII meeting. Objectives To complete the core outcome set for AE by agreeing on core outcome instruments for the domains of quality of life (QoL), long‐term control and itch intensity. Methods A face‐to‐face consensus meeting was held in Tokyo, Japan (8–10 April 2019) including 75 participants (49 healthcare professionals/methodologists, 14 patients, 12 industry representatives) from 16 countries. Consensus decisions were made by presentations of evidence, followed by whole and small group discussions and anonymous voting using predefined consensus rules. Results It was agreed by consensus that QoL should be measured using the Dermatology Life Quality Index (DLQI) for adults, the Children’s Dermatology Life Quality Index (CDLQI) for children and the Infant’s Dermatology Quality of Life Index (IDQoL) for infants. For long‐term control, the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Test (ADCT) should be used. Consensus was not reached over the frequency of data collection for long‐term control. The peak itch numerical rating scale (NRS)‐11 past 24 h was recommended as an additional instrument for the symptom domain in trials of older children and adults. Agreement was reached that all core outcome instruments should be captured at baseline and at the time of primary outcome assessment as a minimum. Conclusions For now, the core outcome set for clinical trials in AE is complete. The specified domains and instruments should be used in all new clinical trials and systematic reviews of eczema treatments.
What is already known about this topic?
Core outcomes sets improve the design and reporting of clinical trials, reduce selective outcome reporting bias and facilitate meta‐analysis of results in systematic reviews. The HOME core outcome set for eczema recommends the inclusion of four core domains in all atopic eczema trials: clinician‐reported signs, patient‐reported symptoms, health‐related quality of life (HrQoL) and long‐term control. Clinician‐reported signs should be captured using the Eczema Area and Severity Index (EASI) and patient‐reported symptoms using the Patient‐Oriented Eczema Measure (POEM).
What does this study add?
The HOME core outcome set is now complete and recommended core outcome instruments have been agreed on for all four domains. Core outcome instruments for HrQoL: Dermatology Life Quality Index (DLQI) for adults, Children’s Dermatology Life Quality Index (CDLQI) for children and Infant’s Dermatology Quality of Life Index (IDQoL) for infants. Core outcome instruments for long‐term control: either the Recap of Atopic Eczema (RECAP) or the Atopic Dermatitis Control Test (ADCT). In addition, itch intensity should be measured using the peak NRS‐11 past 24 h for trials including older children and adults.
What are the clinical implications of this work?
If all future trials of eczema treatments include the HOME core outcome instruments, then trial results will be more readily incorporated into meta‐analyses in systematic reviews and clinical care will be informed by the best available evidence.
Linked Comment: D.F. Murrell and C.F. Paul. Br J Dermatol 2021; 185:13–14.
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Affiliation(s)
- K S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - C A Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - J R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - E Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L A A Gerbens
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - H C Williams
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - J Schmitt
- Center for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - M Gabes
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - L Howells
- Centre of Evidence Based Dermatology, School of Medicine, Nottingham, UK
| | - B L Stuart
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E Grinich
- School of Medicine (Department of Dermatology), Oregon Health & Science University, Portland, OR, USA
| | - T Pawlitschek
- School of Medicine (Department of Dermatology), Oregon Health & Science University, Portland, OR, USA
| | - T Burton
- Patient representative (independent), Nottingham, UK
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | - A Gadkari
- Health Economics and Outcomes Research, Boehringer Ingelheim Inc., Ingelheim, Rheinland-Pfalz, Germany
| | - L Eckert
- Global Dupixent Business Partner, sanofi GHEVA, 1 av. Pierre Brossolette, Chilly-Mazarin, 91380, France
| | - T Ebata
- Chitofuna Dermatology Clinic, Tokyo, Japan
| | - M Boers
- Department of Epidemiology and Data Science, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan
| | - T Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Nosbaum A, Simpson E, Wollenberg A, Lacour JP. Efficacité et tolérance du tralokinumab en monothérapie chez les patients adultes atteints de dermatite atopique modérée à sévère : résultats de deux essais de phase 3 (ECZTRA 1 et ECZTRA 2). Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, Williams HC, Schmitt J, Gabes M, Howells L, Stuart BL, Grinich E, Pawlitschek T, Burton T, Howie L, Gadkari A, Eckert L, Ebata T, Boers M, Saeki H, Nakahara T, Katoh N. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol 2020:bjd.19673. [PMID: 33179283 DOI: 10.1111/bjd.19673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Harmonising Outcome Measures for Eczema (HOME) initiative has established a core outcome set of domains for atopic eczema clinical trials. Previous consensus meetings have agreed upon preferred instruments for clinician-reported signs (Eczema Area and Severity Index - EASI) and patient-reported symptoms (Patient-Oriented Eczema Measure - POEM). This paper reports consensus decisions from the HOME VII meeting. OBJECTIVE To complete the core outcome set for atopic eczema by agreeing upon core outcome instruments for the domains of quality of life, long-term control and itch intensity. METHODS Face-to-face consensus meeting held in Tokyo, Japan (8th to 10th April, 2019) including 74 participants (47 healthcare professionals/methodologists, 14 patients, 13 industry representatives), from 16 countries. Consensus decisions were made by presentations of evidence, followed by whole and small group discussions and anonymous voting using pre-defined consensus rules. RESULTS It was agreed by consensus that quality of life should be measured using the Dermatology Life Quality Index (DLQI) for adults, the Children's Dermatology Life Quality Index (CDLQI) for children, and the Infant's Dermatology Quality of Life Index (IDQoL) for infants. For long-term control, the Recap of Atopic Eczema (RECAP) instrument or the Atopic Dermatitis Control Test (ADCT) should be used. Consensus was not reached over the frequency of data collection for long-term control. The peak itch numerical rating scale(NRS)-11 past 24 hours was recommended as an additional instrument for the symptom domain in trials of older children and adults. Agreement was reached that all core outcome instruments should be captured at baseline and at the time of primary outcome assessment as a minimum. CONCLUSIONS For now, the core outcome set for clinical trials in atopic eczema is complete. The specified domains and instruments should be used in all new clinical trials and systematic reviews of eczema treatments.
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Affiliation(s)
- K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - C A Apfelbacher
- Institute of Social Medicine and Health Systems Research (ISMHSR), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - E Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - P I Spuls
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L A A Gerbens
- Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - J Schmitt
- Center for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - M Gabes
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - B L Stuart
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E Grinich
- School of Medicine, Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - T Pawlitschek
- School of Medicine, Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - T Burton
- Patient Representative (independent), Nottingham, United Kingdom
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | - A Gadkari
- Health Economics and Outcomes Research, Boehringer Ingelheim Inc, Germany
| | - L Eckert
- Global Dupixent Business Partner, sanofi GHEVA, 1 av. Pierre Brossolette, 91 380, Chilly Mazatin, France
| | - T Ebata
- Chitofuna Dermatology Clinic, Tokyo, Japan
| | - M Boers
- Department of Epidemiology and data Science; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan
| | - T Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Simpson E, Hsu C, Chiang J, Armstrong J, Lu X, Gajjar A, Patay Z, Merchant T, Broniscer A, Baker S, Lucas J, Tinkle C. Genetic Determinants of Clinical Response to Radiation Therapy in Diffuse Intrinsic Pontine Glioma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dizon M, Topham C, Haynes D, Brazil M, Chren M, Simpson E. 527 Validation of the Skindex-mini in patients with atopic dermatitis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Liu Y, Yoo A, De La Torre R, Topham C, Hanifin J, Simpson E, Messing R, Kulesz-Martin M, Wang Z. 031 Enhancement of Th2 cell differentiation by TRIM32 deficiency is negatively associated with PKCζ. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guttman-Yassky E, Blauvelt A, Eichenfield L, Paller A, Armstrong A, Drew J, Gopalan R, Simpson E. Lebrikizumab, a High-Affinity IL-13 Inhibitor, Improves Clinical Manifestations in Moderate-to-Severe Atopic Dermatitis: Primary Results From a Randomized, Double-Blinded, Placebo-Controlled, Dose-Ranging, Phase 2b Study. ACTA ACUST UNITED AC 2019. [DOI: 10.25251/skin.3.supp.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Abstract not available.
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Cardoso B, Heads-Baister A, Johnson A, Wake J, Chila T, Simpson E, Hasan A, O'sullivan J, Reinhardt Z, Khushnood A. P3440Can pre-operative echocardiography predict RV failure post-LVAD implantation in children? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
One of the most frequent complications of left ventricular assist device (LVAD) implantation is the development of right ventricular (RV) failure, which occurs in 10%-40% of patients. It is, therefore, essential to identify which LVAD candidates are at risk for RV failure and will require additional RV mechanical support with a biventricular assist device (BiVAD). However, the echocardiographic assessment of the RV is challenging due to its complex geometry and marked load dependence of its function indices. To our knowledge, there is no published evidence regarding which specific RV echocardiographic parameters should inform this decision in the paediatric population.
Aims
We sought to determine which pre-operative RV echocardiographic parameters best correlate with the need for a BiVAD, as opposed to LVAD alone, in a paediatric population undergoing VAD insertion at a tertiary care institution.
Methods
Retrospective review of the pre-operative echocardiograms of children (<18 years) with dilated cardiomyopathy undergoing elective VAD implantation at our institution, from November 2007 to December 2018. Preoperative quantitative and qualitative RV echocardiographic parameters described in the literature to be associated with RV failure after LVAD implantation in adults were collected. Moreover, qualitative RV function was independently assessed by three echocardiographers, blinded to the outcome of the patients.
Results
89 patients were included, 39 (43.8%) males, median age = 1.7 years (IQR = 6.9), median weight = 11.6 kg (IQR = 13.8). 49 (55.1%) patients had an LVAD implanted, whereas 40 (44.9%) were deemed to need biventricular support. 45 (50.6%) patients received an EXCOR Berlin Heart, 16 (18%) a HeartWare HVAD and 28 (31.4%) a Levitronix Centrimag device. Requirement of BiVAD support was significantly more common in patients with moderate to severe RV impairment, as per expert assessment (OR = 2.864; 95% CI: 1.188–6.903, p=0.018), and tricuspid regurgitation > grade III (OR = 3.154; 95% CI: 1.124–8.850, p=0.025). All the other parameters collected – tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitant jet velocity, tricuspid regurgitation duration corrected for heart rate, RV tissue Doppler indices, RV fractional area change, and RV/LV diameter ratio– were not significantly different among groups.
Conclusions
In our paediatric population, expert assessment of RV function and degree of tricuspid regurgitation were strong predictors of RV failure among patients undergoing LVAD implantation, allowing for pre-emptive RVAD implantation and improving patient outcomes.
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Affiliation(s)
- B Cardoso
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Heads-Baister
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Johnson
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - J Wake
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - T Chila
- Freeman Hospital, Paediatric Cardiac Intensive Care department, Newcastle upon Tyne, United Kingdom
| | - E Simpson
- Freeman Hospital, Paediatric Cardiac Intensive Care department, Newcastle upon Tyne, United Kingdom
| | - A Hasan
- Freeman Hospital, Cardiothoracic Surgery department, Newcastle upon Tyne, United Kingdom
| | - J O'sullivan
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - Z Reinhardt
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
| | - A Khushnood
- Freeman Hospital, Paediatric Cardiology department, Newcastle upon Tyne, United Kingdom
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Ortega Loayza A, Friedman M, Anderson M, Greiling T, Cassidy P, Simpson E, Rosenbaum J. 987 Molecular mapping to characterize and differentiate pyoderma gangrenosum from venous ulcers. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ashizawa T, Gagnon C, Groh WJ, Gutmann L, Johnson NE, Meola G, Moxley R, Pandya S, Rogers MT, Simpson E, Angeard N, Bassez G, Berggren KN, Bhakta D, Bozzali M, Broderick A, Byrne JLB, Campbell C, Cup E, Day JW, De Mattia E, Duboc D, Duong T, Eichinger K, Ekstrom AB, van Engelen B, Esparis B, Eymard B, Ferschl M, Gadalla SM, Gallais B, Goodglick T, Heatwole C, Hilbert J, Holland V, Kierkegaard M, Koopman WJ, Lane K, Maas D, Mankodi A, Mathews KD, Monckton DG, Moser D, Nazarian S, Nguyen L, Nopoulos P, Petty R, Phetteplace J, Puymirat J, Raman S, Richer L, Roma E, Sampson J, Sansone V, Schoser B, Sterling L, Statland J, Subramony SH, Tian C, Trujillo C, Tomaselli G, Turner C, Venance S, Verma A, White M, Winblad S. Consensus-based care recommendations for adults with myotonic dystrophy type 1. Neurol Clin Pract 2018; 8:507-520. [PMID: 30588381 PMCID: PMC6294540 DOI: 10.1212/cpj.0000000000000531] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose of review Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects between 1 in 3,000 and 8,000 individuals globally. No evidence-based guideline exists to inform the care of these patients, and most do not have access to multidisciplinary care centers staffed by experienced professionals, creating a clinical care deficit. Recent findings The Myotonic Dystrophy Foundation (MDF) recruited 66 international clinicians experienced in DM1 patient care to develop consensus-based care recommendations. MDF created a 2-step methodology for the project using elements of the Single Text Procedure and the Nominal Group Technique. The process generated a 4-page Quick Reference Guide and a comprehensive, 55-page document that provides clinical care recommendations for 19 discrete body systems and/or care considerations. Summary The resulting recommendations are intended to help standardize and elevate care for this patient population and reduce variability in clinical trial and study environments.
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Oldenburg J, Picard JK, Schwaab R, Brackmann HH, Tuddenham EGD, Simpson E. HLA Genotype of Patients with Severe Haemophilia A due to Intron 22 Inversion with and without Inhibitors of Factor VIII. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1655945] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryMolecular genetic studies have shown that development of antibodies to factor VIII (inhibitors) occurs most frequently in patients with severe haemophilia due to major gene lesions including inversions, stop codons and large deletions. Previous studies of HLA type were performed on inhibitor and non-inhibitor patients with diverse uncharacterised mutations which may have confounded detection of significant associations. We therefore selected a group of patients with a single mutation type, the prevalent intron 22 inversion, with or without inhibitors, to determine HLA genotype. Seventy-one such patients, 42 without and 29 with inhibitors (13 high, 9 low and 7 transient responders) were genotyped for MHC Class I HLA-A, -B, -C and Class II HLA-DQA, -DQB and -DRB loci. No strong correlation of any HLA-allele to inhibitor or non-inhibitor status was found. However, alleles of the haplotype HLA-A3, HLA-B7, HLA-C7, HLA-DQA0102, HLA-DQB0602, HLA-DR15 occurred more often in inhibitor patients. Since the alleles of this extended haplotype are common in the North European population only a very strong association would achieve statistical significance. Further studies of groups of patients similar to those studied here will be needed to confirm or exclude this association.
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Affiliation(s)
- J Oldenburg
- The Institute of Human Genetics, University of Würzburg, Biocentre, Würzburg, Germany
| | - J K Picard
- Transplantation Biology Group, MRC Clinical Sciences Centre, RPMS, London, U.K
| | - R Schwaab
- Institut für Experimentelle Hämatologie und Transfusionsmedizin der Universität Bonn, Bonn, Germany
| | - H H Brackmann
- Institut für Experimentelle Hämatologie und Transfusionsmedizin der Universität Bonn, Bonn, Germany
| | - E G D Tuddenham
- Haemostasis Research Group, MRC Clinical Sciences Centre, RPMS, London, U.K
| | - E Simpson
- Transplantation Biology Group, MRC Clinical Sciences Centre, RPMS, London, U.K
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Maynard M, Apekey T, Kime N, Walsh D, Simpson E, Copeman J. 7.1-O5Views on risk, prevention and management of type 2 diabetes among UK Black Caribbean. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Maynard
- Leeds Beckett University, United Kingdom
| | - T Apekey
- Leeds Beckett University, United Kingdom
| | - N Kime
- Leeds Beckett University, United Kingdom
| | - D Walsh
- Leeds Beckett University, United Kingdom
| | - E Simpson
- Leeds Beckett University, United Kingdom
| | - J Copeman
- Leeds Beckett University, United Kingdom
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Chalmers JR, Thomas KS, Apfelbacher C, Williams HC, Prinsen CA, Spuls PI, Simpson E, Gerbens LAA, Boers M, Barbarot S, Stalder JF, Abuabara K, Aoki V, Ardeleanu M, Armstrong J, Bang B, Berents TL, Burton T, Butler L, Chubachi T, Cresswell-Melville A, DeLozier A, Eckert L, Eichenfield L, Flohr C, Futamura M, Gadkari A, Gjerde ES, van Halewijn KF, Hawkes C, Howells L, Howie L, Humphreys R, Ishii HA, Kataoka Y, Katayama I, Kouwenhoven W, Langan SM, Leshem YA, Merhand S, Mina-Osorio P, Murota H, Nakahara T, Nunes FP, Nygaard U, Nygårdas M, Ohya Y, Ono E, Rehbinder E, Rogers NK, Romeijn GLE, Schuttelaar MLA, Sears AV, Simpson MA, Singh JA, Srour J, Stuart B, Svensson Å, Talmo G, Talmo H, Teixeira HD, Thyssen JP, Todd G, Torchet F, Volke A, von Kobyletzki L, Weisshaar E, Wollenberg A, Zaniboni M. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). Br J Dermatol 2018; 178:e332-e341. [PMID: 29672835 DOI: 10.1111/bjd.16543] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/11/2022]
Abstract
This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
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Affiliation(s)
- J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C A Prinsen
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - P I Spuls
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - E Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, U.S.A
| | - L A A Gerbens
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - M Boers
- VU University Medical Center, Amsterdam, the Netherlands
| | - S Barbarot
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - J F Stalder
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, U.S.A
| | - V Aoki
- University of São Paulo Medical School, São Paulo, Brazil
| | - M Ardeleanu
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | | | - B Bang
- LEO Pharma, Ballerup, Denmark
| | | | | | - L Butler
- National Eczema Association, San Rafael, CA, U.S.A
| | - T Chubachi
- GlaxoSmithKline, Research Triangle Park, NC, U.S.A
| | | | - A DeLozier
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - L Eichenfield
- Rady Children's Hospital, University of California San Francisco, San Diego, CA, U.S.A
| | - C Flohr
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - A Gadkari
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | - E S Gjerde
- The Psoriasis and Eczema Association of Norway, Oslo, Norway
| | - K F van Halewijn
- Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | | | - L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | | | - H A Ishii
- Brazilian Atopic Dermatitis Association (AADA), São Paulo, Brazil
| | - Y Kataoka
- Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | | | - W Kouwenhoven
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - S M Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K
| | - Y A Leshem
- Beilinson Hospital and Tel Aviv University, Petah Tikva and Tel Aviv, Israel
| | - S Merhand
- Association Française de l'Eczéma, Redon, France
| | | | - H Murota
- Department of Dermatology, Osaka University, Suita, Japan
| | - T Nakahara
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - F P Nunes
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - U Nygaard
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - Y Ohya
- National Centre for Child Health and Development, Tokyo, Japan
| | - E Ono
- Osaka University, Osaka, Japan
| | - E Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - N K Rogers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - G L E Romeijn
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A V Sears
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - J A Singh
- Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, U.S.A
| | - J Srour
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU - München, Munich, Germany
| | - B Stuart
- Primary Care and Population Sciences Division, University of Southampton, Southampton, U.K
| | - Å Svensson
- Department of Dermatology and Venereology, Lund University, Malmö, Sweden
| | - G Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | - H Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | | | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - G Todd
- University of Cape Town, Cape Town, South Africa
| | - F Torchet
- Association Française de l'Eczéma, Redon, France
| | - A Volke
- Department of Dermatology, University of Tartu, Tartu, Estonia
| | - L von Kobyletzki
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.,CF Wahlgren, Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden.,Department of Dermatology, Venereology and Allergy University Hospital Schleswig-Holstein, Kiel, Germany
| | - E Weisshaar
- Department of Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, Heidelberg, Germany
| | | | - M Zaniboni
- University of São Paulo, Campinas, Brazil
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van Schaik IN, Mielke O, Sabet A, George K, Roberts L, Carne R, Blum S, Henderson R, Van Damme P, Demeestere J, Larue S, Pinard D'Amour CA, Bril V, Breiner A, Kunc P, Valis M, Sussova J, Kalous T, Talab R, Bednar M, Toomsoo T, Rubanovits I, Gross-Paju K, Sorro U, Saarela M, Auranen M, Pouget J, Attarian S, Le Masson G, Wielanek-Bachelet AC, Desnuelle C, Delmont E, Clavelou P, Aufauvre D, Schmidt J, Zschuentssch J, Sommer C, Kramer D, Hoffmann O, Goerlitz C, Haas J, Chatzopoulos M, Yoon MS, Gold R, Berlit P, Jaspert-Grehl A, Liebetanz D, Kutschenko A, Stangel M, Trebst C, Baum P, Then Bergh F, Klehmet J, Meisel A, Klostermann F, Oechtering J, Lehmann H, Schroeter M, Hagenacker T, Mueller D, Sperfeld AD, Bethke F, Hartung HP, Drory V, Algom A, Yarnitsky D, Murinson BB, Di Muzio A, Ciccocioppo F, Sorbi S, Mata S, Schenone A, Grandis M, Lauria G, Cazzato D, Antonini G, Morino S, Cocito D, Zibetti M, Yokota T, Ohkubo T, Kanda T, Kawai M, Kaida K, Onoue H, Kuwabara S, Mori M, Iijima M, Ohyama K, Sobue G, Baba M, Tomiyama M, Nishiyama K, Akutsu T, Yokoyama K, Kanai K, van Schaik IN, Eftimov F, Notermans NC, Visser NA, Faber C, Hoeijmakers JG, Merkies IS, van Geloven N, Rejdak K, Chyrchel-Paszkiewicz U, Casanovas Pons C, Alberti Aguiló MA, Gamez J, Figueras M, Marquez Infante C, Benitez Rivero S, Lunn M, Morrow J, Gosal D, Lavin TM, Melamed I, Testori A, Ajroud-Driss S, Menichella D, Simpson E, Chi-Ho Lai E, Dimachkie M, Barohn RJ, Beydoun S, Johl H, Lange D, Shtilbans A, Muley S, Ladha S, Freimer M, Kissel J, Latov N, Chin R, Ubogu E, Mumfrey S, Rao THP, MacDonald P, Sharma K, Gonzalez G, Allen J, Walk D, Hobson-Webb L, Gable K, Lewis RA, Cornblath DR, Lawo JP, Praus M, Durn BL, Mielke O. Intravenous versus subcutaneous immunoglobulin – Authors' reply. Lancet Neurol 2018; 17:393-394. [DOI: 10.1016/s1474-4422(18)30109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
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Andronikou S, Arthur S, Simpson E, Chopra M. Selective duodenography for controlled first-pass bolus distention of the duodenum in neonates and young children with bile-stained vomiting. Clin Radiol 2018; 73:506.e1-506.e8. [PMID: 29397912 DOI: 10.1016/j.crad.2017.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Abstract
AIM To compare "selective duodenograms" performed through nasogastric tubes advanced into the proximal duodenum against traditional contrast studies regarding visualisation of a first-pass bolus distention of the duodenum and frequency of inconclusive results. MATERIALS AND METHODS Retrospective comparison of "selective duodenograms" and traditional upper gastrointestinal contrast studies in neonates with bile-stained vomiting, regarding demonstration of the duodenal C-loop, first-pass bolus capture, degree of distention of the duodenum, and number of inconclusive studies. Statistical comparison was performed using the two-tailed Fishers exact and chi-squared tests. RESULTS There were 31 "selective duodenograms" and 70 traditional studies. The C-loop was demonstrated in 93% of traditional studies versus 100% in "selective duodenograms" and was demonstrated significantly more often during the first-pass (94% versus 73%; p=0.018) and more often with distention of the duodenum for "selective duodenography" (94% versus 56%, p<0.001). There were more inconclusive traditional studies (7% versus 3%; non-significant). CONCLUSION Emergency upper gastrointestinal tract studies performed in neonates using the "selective duodenogram" technique demonstrated the duodenum with 100% success, with significantly more frequent first-pass bolus visualisation and duodenal distention than traditional studies. The five (7%) inconclusive traditional studies, present a significant diagnostic conundrum in the emergency setting because emergency surgery must be contemplated without proof.
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Affiliation(s)
- S Andronikou
- Department of Paediatric Radiology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK; University of Bristol, Senate House, Tyndall Ave, Bristol, BS8 1TH, UK.
| | - S Arthur
- Department of Paediatrics, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
| | - E Simpson
- Department of Paediatric Radiology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
| | - M Chopra
- Department of Paediatric Radiology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
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van Schaik IN, Bril V, van Geloven N, Hartung HP, Lewis RA, Sobue G, Lawo JP, Praus M, Mielke O, Durn BL, Cornblath DR, Merkies ISJ, Sabet A, George K, Roberts L, Carne R, Blum S, Henderson R, Van Damme P, Demeestere J, Larue S, D'Amour C, Bril V, Breiner A, Kunc P, Valis M, Sussova J, Kalous T, Talab R, Bednar M, Toomsoo T, Rubanovits I, Gross-Paju K, Sorro U, Saarela M, Auranen M, Pouget J, Attarian S, Le Masson G, Wielanek-Bachelet A, Desnuelle C, Delmont E, Clavelou P, Aufauvre D, Schmidt J, Zschuentssch J, Sommer C, Kramer D, Hoffmann O, Goerlitz C, Haas J, Chatzopoulos M, Yoon R, Gold R, Berlit P, Jaspert-Grehl A, Liebetanz D, Kutschenko A, Stangel M, Trebst C, Baum P, Bergh F, Klehmet J, Meisel A, Klostermann F, Oechtering J, Lehmann H, Schroeter M, Hagenacker T, Mueller D, Sperfeld A, Bethke F, Drory V, Algom A, Yarnitsky D, Murinson B, Di Muzio A, Ciccocioppo F, Sorbi S, Mata S, Schenone A, Grandis M, Lauria G, Cazzato D, Antonini G, Morino S, Cocito D, Zibetti M, Yokota T, Ohkubo T, Kanda T, Kawai M, Kaida K, Onoue H, Kuwabara S, Mori M, Iijima M, Ohyama K, Baba M, Tomiyama M, Nishiyama K, Akutsu T, Yokoyama K, Kanai K, van Schaik I, Eftimov F, Notermans N, Visser N, Faber C, Hoeijmakers J, Rejdak K, Chyrchel-Paszkiewicz U, Casanovas Pons C, Alberti Aguiló M, Gamez J, Figueras M, Marquez Infante C, Benitez Rivero S, Lunn M, Morrow J, Gosal D, Lavin T, Melamed I, Testori A, Ajroud-Driss S, Menichella D, Simpson E, Chi-Ho Lai E, Dimachkie M, Barohn R, Beydoun S, Johl H, Lange D, Shtilbans A, Muley S, Ladha S, Freimer M, Kissel J, Latov N, Chin R, Ubogu E, Mumfrey S, Rao T, MacDonald P, Sharma K, Gonzalez G, Allen J, Walk D, Hobson-Webb L, Gable K. Subcutaneous immunoglobulin for maintenance treatment in chronic inflammatory demyelinating polyneuropathy (PATH): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol 2018; 17:35-46. [DOI: 10.1016/s1474-4422(17)30378-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
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De Bruin-Weller M, Gadkari A, Simpson E, Cork M, Puig L, Girolomoni G, Wollenberg A, Chen Z, Radin A, Shumel B, Ardeleanu M, Plaum S, Eckert L. P479 Dupilumab improves patient-reported outcomes in atopic dermatitis patients inadequately controlled, intolerant, or inadvisable for cyclosporine-A. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Berry JD, Paganoni S, Atassi N, Macklin EA, Goyal N, Rivner M, Simpson E, Appel S, Grasso DL, Mejia NI, Mateen F, Gill A, Vieira F, Tassinari V, Perrin S. Phase IIa trial of fingolimod for amyotrophic lateral sclerosis demonstrates acceptable acute safety and tolerability. Muscle Nerve 2017; 56:1077-1084. [PMID: 28662296 PMCID: PMC5724488 DOI: 10.1002/mus.25733] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2017] [Indexed: 11/11/2022]
Abstract
Introduction Immune activation has been implicated in progression of amytrophic lateral sclerosis (ALS). Oral fingolimod reduces circulating lymphocytes. The objective of this phase IIa, randomized, controlled trial was to test the short‐term safety, tolerability, and target engagement of fingolimod in ALS. Methods Randomization was 2:1 (fingolimod:placebo). Treatment duration was 4 weeks. Primary outcomes were safety and tolerability. Secondary outcomes included circulating lymphocytes and whole‐blood gene expression. Results Thirty participants were randomized; 28 were administered a drug (fingolimod 18, placebo 10). No serious adverse events occurred. Adverse events were similar by treatment arm, as was study discontinuation (2 fingolimod vs. 0 placebo, with no statistical difference). Forced expiratory volume in 1 second (FEV1) and FEV1/slow vital capacity changes were similar in the fingolimod and placebo arms. Circulating lymphocytes decreased significantly in the fingolimod arm (P < 0.001). Nine immune‐related genes were significantly downregulated in the fingolimod arm, including forkhead box P3 (P < 0.001) and CD40 ligand (P = 0.003). Discussion Fingolimod is safe and well‐tolerated and can reduce circulating lymphocytes in ALS patients. Muscle Nerve56: 1077–1084, 2017
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Affiliation(s)
- James D Berry
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Sabrina Paganoni
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Nazem Atassi
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric A Macklin
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA.,Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Namita Goyal
- Department of Neurology, University of California, Irvine, Orange, California, USA
| | - Michael Rivner
- Department of Neurology, Augusta University Medical Center, Augusta, Georgia, USA
| | - Ericka Simpson
- Department of Neurology, Methodist Hospital, Houston, Texas, USA
| | - Stanley Appel
- Department of Neurology, Methodist Hospital, Houston, Texas, USA
| | - Daniela L Grasso
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA
| | - Nicte I Mejia
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA
| | - Farrah Mateen
- Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, Massachusetts, 02114, USA
| | - Alan Gill
- ALS Therapy Development Institute, Cambridge, Massachusetts, USA
| | - Fernando Vieira
- ALS Therapy Development Institute, Cambridge, Massachusetts, USA
| | | | - Steven Perrin
- ALS Therapy Development Institute, Cambridge, Massachusetts, USA
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Nicholson K, Murphy A, McDonnell E, Shapiro J, Simpson E, Glass J, Mitsumoto H, Forshew D, Miller R, Atassi N. Improving symptom management for people with amyotrophic lateral sclerosis. Muscle Nerve 2017; 57:20-24. [PMID: 28561886 DOI: 10.1002/mus.25712] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 05/02/2017] [Accepted: 05/27/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Symptomatic management is the main focus of ALS clinical care. We aim to report the prevalence of ALS-related symptoms and characterize self-reported symptomatic management. METHODS A symptom management survey developed by the Muscular Dystrophy Association Clinical Research Network was completed by ALS registrants. Logistic regression identified potential predictors of symptom prevalence, severity, and treatment. RESULTS A total of 567 ALS participants reported fatigue (90%), muscle stiffness (84%), and muscle cramps (74%) as most prevalent symptoms. Fatigue (18%), muscle stiffness (14%), and shortness of breath (12%) were most bothersome. Although fatigue was the most prevalent symptom, it was also least treated (10%). Neither location of care nor disease duration was associated with symptom prevalence, severity, or probability of receiving treatment. DISCUSSION This large patient-reported symptom survey suggests that fatigue is the most prevalent, bothersome, and undertreated ALS symptom. Improving ALS symptom management is an unmet medical need and clinical trials of symptomatic treatments are needed. Muscle Nerve 57: 20-24, 2018.
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Affiliation(s)
- Katharine Nicholson
- Harvard Medical School, Neurological Clinical Research Institute (NCRI), Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, Massachusetts, 02114, USA
| | - Alyssa Murphy
- Harvard Medical School, Neurological Clinical Research Institute (NCRI), Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, Massachusetts, 02114, USA
| | - Erin McDonnell
- Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts, USA
| | - Jordan Shapiro
- Department of Management Science and Engineering, Stanford University, Stanford, California, USA
| | - Ericka Simpson
- Department of Neurology, Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Jonathan Glass
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Hiroshi Mitsumoto
- Department of Neurology, Eleanor and Lou Gehrig MDA/ALS Research Center, Columbia University Medical Center, New York, New York, USA
| | - Dallas Forshew
- Department of Neurology, Forbes Norris MDA/ALS Research Center, California Pacific Medical Center, San Francisco, California, USA
| | - Robert Miller
- Department of Neurology, Forbes Norris MDA/ALS Research Center, California Pacific Medical Center, San Francisco, California, USA
| | - Nazem Atassi
- Harvard Medical School, Neurological Clinical Research Institute (NCRI), Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, Massachusetts, 02114, USA
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Liu Y, Wang Z, De La Torre R, Barling A, Hornick N, Hanifin J, Simpson E, Kulesz-Martin M. 640 Enhancement of Th2 polarization by Trim32 deficiency. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Bolton E, Ferguson A, Simpson B, Al-naqeeb J, Simpson E. 420 The effects of bathing, showering and petrolatum on skin barrier function. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sacotte R, Vakharia P, Chopra R, Patel N, Immaneni S, White T, Kantor R, Hsu D, Simpson E, Silverberg J. 383 Establishing severity strata for 5 different patient-reported outcomes in adults with atopic dermatitis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Al-naqeeb J, Danner S, Fagnan L, Ramsey K, Michaels L, Mitchell J, Branca K, Morris C, Nease D, Zittleman L, Levy B, Daly J, Hahn D, Dolor R, Hanifin J, Tofte S, Zuckerman K, Hansis K, Gundersen M, Dillon K, Block J, Karr F, Dunbrasky S, Lapidus J, Siebe K, Simpson E. 195 The burden of childhood atopic dermatitis in U.S. primary care settings. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spuls P, Gerbens L, Simpson E, Apfelbacher C, Chalmers J, Thomas K, Prinsen C, von Kobyletzki L, Singh J, Williams H, Schmitt J. Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement. Br J Dermatol 2017; 176:979-984. [DOI: 10.1111/bjd.15179] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2016] [Indexed: 12/25/2022]
Affiliation(s)
- P.I. Spuls
- Department of Dermatology; Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - L.A.A. Gerbens
- Department of Dermatology; Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - E. Simpson
- Department of Dermatology; Oregon Health & Sciences University; Portland OR U.S.A
| | - C.J. Apfelbacher
- Medical Sociology; Institute of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - J.R. Chalmers
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - K.S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - C.A.C. Prinsen
- Department of Epidemiology and Biostatistics; EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam the Netherlands
| | - L.B. von Kobyletzki
- Institution for Clinical Science; Department of Dermatology; Lund University; Malmö Sweden
| | - J.A. Singh
- Department of Rheumatology and Division of Epidemiology; University of Alabama; Birmingham AL U.S.A
- Veterans Affairs Medical Center; Birmingham AL U.S.A
- Mayo Clinic College of Medicine; Rochester MN U.S.A
| | - H.C. Williams
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham U.K
| | - J. Schmitt
- Centre for Evidence-based Healthcare; University Hospital Carl Gustav Carus; TU; Dresden Germany
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Sadick N, Bohnert K, Papp K, Simpson E, Beck L, Blauvelt A, Gooderham M, Wu R, Graham N, Pirozzi G, Sutherland E, Ardeleanu M. Efficacité et tolérance du dupilumab dans la dermatite atopique modérée à sévère chez l’adulte : analyse poolée de deux essais cliniques de phase 2. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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